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189) , , , 2014, 453.
190) , ,
Eleanor D. Kinney.,
"Provisions for Health and Health Care in the Constitutions of the Countries of the World",
Cornell Int'l Law. J., Vol 37, (2004), 289 .
191) 251. , . 2,
, , .
192) .
193) Art. 41 1 The Confederation and the Cantons shall, as a complement to personal
responsibility. and private initiative, endeavour to ensure that: a. everyone has access to
social security; b. everyone has access to the health care that they require.
194) Art. 32 The Republic safeguards health as a fundamental right of the individual and as a
collective interest, and guarantees free medical care to the indigent. No one may be obliged
to undergo any health treatment except under the provisions of the law. The law may not
under any circumstances violate the limits imposed by respect for the human person.
195) ARTICLE 56. Everyone has the right to live in a healthy, balanced environment. It is the
duty of the state and citizens to improve the natural environment, and to prevent
environmental pollution. To ensure that everyone leads their lives in conditions of physical
- 146 -
. 41196)
,
.
, 196197198
.197)
3.
and mental health and to secure cooperation in terms of human and material resources
through economy and increased productivity, the state shall regulate central planning and
functioning of the health services. The state shall fulfil this task by utilizing and supervising
the health and social assistance institutions, in both the public and private sectors. In order
to establish widespread health services general health insurance may be introduced by law.
196) Article 41 1. Everyone shall have the right to health protection and medical aid. Medical
aid in state and municipal health establishments shall be rendered to individuals gratis, at the
expense of the corresponding budget, insurance contributions, and other proceeds. 2. In the
Russian Federation federal programmes of protecting and strengthening the health of the
population shall be financed by the State; measures shall be adopted to develop state,
municipal and private health services; activities shall be promoted which facilitate the
strengthening of health, the development of physical culture and sport, ecological and
sanitary-epidemiological well-being.3. The concealment by officials of the facts and
circumstances posing a threat to the life and health of people shall entail responsibility
according to the federal law.
197) Eleanor D. Kinney., "Provisions for Health and Health Care in the Constitutions of the
Countries of the World", Cornell Int'l Law. J., Vol 37, (2004), 310 .
- 147 -
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, , ISSUE
PAPER, 2013,5.
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2012. 10.
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1999. 1. 26. 9714224
2001. 3. 23. 994204
2005. 10. 28. 200313434
2007. 6. 15. 200610368
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1994.6.30. 929
1995.7.21. 9314 7-2
1996.10.31. 947, 8-2.
2000.4.27. 9816
2000.6.29, 99289, 12-1
2000.8.31. 9712, 12-2
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2003.10.30. 2000801, 15-2
2002.10.31. 9976, 2000505()
2003.12.18 2001 543, 15-2
2003.12.18, 20021, 15-2(),
2004.10.28. 9991
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- -
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2015.7.25 ,(
(http://www.etymonline.com)
(http://www.who.int)
(http://dic.daum.net)
(http://www.bl.uk)
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Abstract
Challenges and Improvement measures of National
Health Insurance Act for realization of the Right to Health
- through Constitutional Issues-
Health is a precondition to maintain community and its homogeneity by
allowing individuals to share their social and cultural values. Our
constitution recognizes health as a national matter and provides protection
indirectly based on the human dignity and the right to happiness under
Article 10, the environmental right under the first clause of Article 35 of
the Constitution, and directly based on the right to have basic standard of
human life under Article 34 and the right to health under Article 36 of the
Constitution. This task of the Constitution becomes materialized through
the National Health Insurance Act.
Health care benefits provided by the National Health Insurance Act
should be appropriate to solve health care challenges and its decision
process should be reasonable. In addition, the foundation to guarantee
health rights of citizens should be established by making the system where
people can choose health care services rationally including the uncovered
services, which are beyond the scope of the health insurance. Therefore,
the management group operating the health insurance needs to suggest
plans that can organize and operate the health insurance realizing the
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health rights of citizens and can solve challenges including the ones caused
by the uncovered services. In this respect, the current National Health
Insurance Act should solve the challenges mentioned below.
First, the benefit package that is covered by the National Health
Insurance Act cannot directly solve the health risk of citizens. Burden
caused by the uncovered services is highly likely to cause giving up of
health or the economic plight. However, the area of the uncovered services
is not only the area of the health insurance system but the area where the
contracts between the health care facilities and individuals occur, which
blocks the direct intervention by the country. Therefore, the coverage
should be extended by switching the uncovered area to the covered area
and this can be achieved by extending the range of the benefit package.
At the same time, in case of the uncovered services, providing information
on cost and effect that enable rational cost decision between patients and
health care providers will guarantee citizens right of choice for health care
services and the detailed administrative enactment is required such as
minimizing the liberty infringement of health care professional performing.
Second, the National Health Insurance Act lacks the legitimacy of formal
and procedural requirements in the cost decision process of health care
services. In terms of formality, the organization of the Health Insurance
Policy Committee which decides the cost of health insurance benefits is not
structured in a way that can obtain trust from health care professionals,
the health care providers. The current human resource of the committee is
structured in a way to represent the voice of the insurers easily and this
drops not only the trust towards the committee and but also the
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acceptability of the decision among the health care professionals. Therefore,
it is required to have the proper human resources that can equally speak
for interests of both insurers and providers. In terms of the procedure, the
Minister of Health and Welfare makes a decision through a public
announcement unless the contract for the benefit package is made between
the insurers and the providers. However, it needs further consideration on
whether there are any alternatives other than just confirming the cost, one
of the important elements of the contract, by the Minister without
settlement out of court. For example, when there is no settlement out of
court, it may be possible to apply the current cost to the following year
and make revision when the consensus becomes available through
continuous publicity.
Third, the cost should be used efficiently in order to maintain the
substantiality of the health insurance system and the rational operating
system should be prepared so that the misuse and abuse can be
minimized. In Korea, an independent institution, the Health Insurance
Review and Assessment Service (HIRA), not the insurer, performs review
and assessment of appropriateness of handling the premium. Therefore,
HIRA should secure the position that can review and assess the
appropriateness of the health care cost based on the scientific and
objective evidence with the structure independently of the insurer.
However, according to the current National Health Insurance Act, HIRA
has its structure difficult to perform review and assessment independently.
Therefore, the legislation should be improved so that it can secure its
normative independence.
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The nation should put its effort to make citizens lead a life worthy of
human dignity by actively solving their health problems. Though it may be
impossible to realize the goal in reality, it is the countrys mission to put
its maximum effort. But one of its important role is to induce the
agreement from the community by actively and rationally providing
explanation on the limitation of fundamental rights and duties of individuals
that are caused by the countrys role performance. As for the limitation of
fundamental rights, if possible, additional efforts to mitigate the limitation
range are required. The country can remain as what it really is when it
actively protects its citizens from danger. This is the reason why the
nation should protect its citizens health more actively.
Key words: Health rights, National Health Insurance Act, Health care
benefits, Uncovered services, Right of Acceptability, Right
of Accessibility to Health Care, Right of Choice, Social
Fundamental rights